A system for generating data relating to a tissue core biopsy, and the use of the system to detect tissue abnormalities, in particular cancerous tissue, in a patient

ABSTRACT

A system for generating data relating to a tissue core comprises a core needle biopsy module configured to obtain a tissue core from a locus within the body, and a tissue disintegration module operably connected to the core needle biopsy module and configured to receive a tissue core from the core needle biopsy module and convert at least a portion of the tissue core into gaseous tissue molecules. The system also comprises first vacuum pump means configured to convey a tissue core from the needle biopsy module to the tissue disintegration module, and second vacuum pump means configured to convey gaseous tissue molecules from the tissue disintegration module to an analyser module.

TECHNICAL FIELD

The invention relates to systems for generating data relating to tissuecore biopsies. In particular, the invention relates to systems forgenerating data relating to a patients cancer status, and methods fordetecting cancer in patients.

BACKGROUND TO THE INVENTION

Breast cancer continues to affect approximately one woman in ten in thewestern world and despite the phenomenal advances in recent years themortality rate is as high as 35%. Diagnosis of breast cancer generallyinvolves a triple assessment process, which includes a visit to a clinicor hospital for assessment for a clinical assessment and examination,radiology imaging tests and a core needle biopsy and or Fine needleaspiration biopsy to be taken, and subsequent analysis of the biopsy bya Histopathologist or Cytologist.

Tissue core biopsies are taken using a needle punch device. The devicegenerally comprises a needle having a hollow core and a retractablesheath. Some needle biopsy systems include a vacuum pump in fluidcommunication with the hollow core of the needle. In use, the device isinserted into the breast and the needle tip generally inserted into amass within the breast with the aide of ultrasound and less frequentlymammography and magnetic resonance imaging. Once in situ, retraction ofthe sheath causes adjacent tissue to herniate into the hollow core ofthe needle, whereby extension of the sheath cuts the tissue leaving asequestered core within the needle, which is withdrawn, by the action ofthe vacuum pump into a collection chamber. Generally, the needle iscapable of rotation about its longitudinal axis, allowing acircumferential series of core needle biopsy samples to be obtained at adesired locus. In the case of mammographic biopsies, these are usuallyobtained using stereotactic guidance. The core biopsies thus obtainedmaybe analysed by a radiologist for the presence of microcalcificationswithin the sequestered core biopsy samples, prior to being sent to apathology laboratory for histological analysis by a pathologist.

The core needle biopsy device may also include a conduit for deliveringvariable amounts of local anaesthetic and placing a localization markerto the said sequestered outlets for delivery to the site of the extrudedlongitudinal strips of core biopsy tissue product and/or tissue materialproduct.

As the histological analysis process may take several days to completeafter the biopsy is taken, this necessitates that the patient has tomake a first visit to the clinic or hospital for a biopsy to be taken,and a second visit to meet with the clinician to receive the diagnosis.In some cases, if the biopsy taken from the margin or satellite tissueis determined to be cancerous, further hospital visits maybe requiredfor additional radiology imaging tests and further core biopsy needlebiopsy tissue samples to be taken. It is one object of the invention toovercome at least one of these problems.

The IKNIFE is a surgical tool that helps surgeons detect cancer in apatient in real time while the patient is undergoing surgery. The IKNIFEcomprises a surgical knife having a heating element that is capable ofconverting tissue to gaseous tissue molecules (ionization), a massspectrometer, and a vacuum pump and conduit configured to convey theionized tissue to the mass spectrometer where the gaseous ions areanalysed to determine whether the tissue is cancerous. The device isused during surgery to resect tumours, and in particular to cut awaymargins and simultaneously determine in real time whether the marginsare cancerous or not. The IKNIFE device is described in WO2010136887.Methods for subcellular analysis by laser ablation electrospray massspectrometry are described in US2011/0215233. Methods for analysis ofnon-living substrates using an electrosurgical knife to generate ionsand a mass spectrometer to analyse the ions is described in GB2491486.

STATEMENTS OF INVENTION

The Applicants have discovered that the underlying concept of the IKNIFEcan be translated into a needle biopsy device and employed to providereal time diagnostic information to a clinician during a core needlebiopsy procedure, thus allowing a clinician to tailor the biopsyprocedure, avoid having to take excessive number of biopsies, andprovide the patient with an initial diagnosis immediately after theprocedure. The invention relates to a system comprising a needle biopsymodule, a tissue disintegration module operatively linked to the needlebiopsy module for receipt of a tissue core from the needle biopsymodule, and optionally an analyser operatively linked to thedisintegration module for receipt of gaseous tissue molecules from thedisintegration module. In a first embodiment, the system is provided asa “plug-and-play” system in which the tissue disintegration module isremovably attached to the needle biopsy module and can be easilydetached and replaced with a removable tissue core collection moduleadapted to collects tissue cores for further analysis. In thisembodiment, the system can be adapted to analyse gaseous moleculesgenerated from tissue cores by means of mass spectrometry or NMR, orcollect tissue cores for analysis by other means for example histologyor cytology. In a different, but linked embodiment, the system cancomprise both tissue disintegration and tissue collection modules, andadjustment means for alternatively aligning either the tissuedisintegration module or tissue collection module with the needle biopsymodule for receipt of a tissue core.

Thus, in a first aspect, the invention provides a system for generatingdata relating to a tissue core, comprising:

-   -   a core needle biopsy module configured to obtain a tissue core        from a locus within the body;    -   a tissue disintegration module operably connected to the core        needle biopsy module and configured to receive a tissue core        from the core needle biopsy module and convert at least a        portion of the tissue core into gaseous tissue molecules; and    -   a conveying module operable to convey a tissue core from the        needle biopsy module to the tissue disintegration module and/or        convey gaseous tissue molecules from the tissue disintegration        module to an analyser module.

In one embodiment, the system comprises an analyser module. In oneembodiment, the analyser module is operably connected to the conveyingmodule for receipt of the gaseous tissue molecules from thedisintegration module. In one embodiment, the analyser module isconfigured to analyse the gaseous tissue chemicals or molecules, andgenerate data relating to the tissue core based on the gaseous tissuemolecules.

In one embodiment, the analyser module comprises a mass spectrometer.However, other analysers are envisaged such as for example nuclearmagnetic resonance spectroscopy or gas chromatography.

In one embodiment, the core needle biopsy module and tissuedisintegration module are provided as a single unit, and wherein thetissue disintegration module is removably attached to the core needlebiopsy module. In one embodiment, the system comprises a tissue corecollection module configured for removable attachment to the core needlebiopsy module in place of the tissue disintegration module forcollection of one or more tissue cores from the core needle biopsymodule. This allow the system to be used in a disintegration mode whereone or more cores are optionally converted to gaseous molecules whichare analysed by for example mass spectrometry, and then typicallyadapted to a core collection mode where obtained cores are collected forsubsequent analysis intact (i.e. by means of cytology or histology) byremoving the tissue disintegration module and replacing it with thetissue collection module.

In another embodiment, the system comprises a tissue core collectionmodule, wherein the tissue disintegration module, the core needle biopsymodule, and the tissue core collection module are typically provided asa single unit, wherein the unit is generally adjustable from a firstconfiguration in which the tissue disintegration module is aligned withthe core needle biopsy module for receipt of a tissue core therefrom toa second configuration in which the tissue core collection module isaligned with the core needle biopsy module for receipt of a tissue coretherefrom.

In one embodiment, the unit comprises adjustment means for aligning thecore needle biopsy module with different modules, for example, thetissue core collection module and the tissue disintegration module. Inone embodiment, the tissue core collection module and the tissuedisintegration module are provided on a first rotor configured forrotation from at least the first configuration to at least the secondconfiguration.

In one embodiment, the tissue core collection module and the tissuedisintegration module are contained within a single chamber. In oneembodiment, the conveying module comprises a vacuum pump. In oneembodiment, the single chamber is in fluid communication with the vacuumpump for evacuation of the chamber.

In one embodiment, the conveying module comprises a pump (i.e. a vacuumpump) and associated conduits. In one embodiment, the conveying modulecomprises a first conveying module configured to convey a tissue corefrom the needle biopsy module to the tissue disintegration module andsecond conveying module configured to convey gaseous tissue moleculesfrom the tissue disintegration module to an analyser module. In oneembodiment, the first and second conveying modules share a single pump.In another embodiment, the first and second conveying modules haveseparate pumps.

In one embodiment, the first conveying module comprises a vacuum pumpand a first conduit providing fluid communication between the vacuumpump and the tissue disintegration module. Thus, when the vacuum pump isactuated, and when the tissue disintegration module is operablyconnected (i.e. aligned) with the needle biopsy module, negativepressure is typically generated in the tissue disintegration modulecausing any core in the needle biopsy module to be withdrawn into thetissue disintegration module.

In one embodiment, the second conveying module comprises a vacuum pumpoperably connected to a second conduit providing fluid communicationbetween an analyser and the tissue disintegration module. Thus, when thevacuum pump is actuated, negative pressure is typically generated in thetissue disintegration module causing any gaseous molecules in the tissuedisintegration module to be withdrawn into the analyser module throughthe second conduit.

In one embodiment, distal ends of the first and second conduits aredisposed on a second rotor that is operably connected to the first rotorfor rotation relative to the first rotor from a first configuration inwhich the first conduit is aligned with the tissue disintegration moduleto a second configuration in which the second conduit is aligned withthe tissue disintegration module. In one embodiment, the rotor has firstand second apertures in fluid communication with the first and secondconduits. Thus, rotation of the first rotor relative to the second rotortypically allows the system alternate between a first conveying mode inwhich tissue core in the needle biopsy module is conveyed to the tissuedisintegration module and a second conveying mode in which gaseousmolecules generated in the tissue disintegration module are conveyed tothe analyser module.

In one embodiment, the disintegration module comprises an inner supportconfigured to receive a tissue core biopsy and convert at least a partof the tissue core biopsy into gaseous tissue molecules, and an outergas impermeable chamber.

In one embodiment, the system comprises a fluid delivery moduleconfigured to deliver fluid through the needle biopsy module. In oneembodiment the fluid is a gas. In one embodiment, the fluid is a liquid.In one embodiment, the fluid is a solvent. In one embodiment, the fluidis or comprises a catalyst. The fluid may be an anaesthetic or apharmacologically active agent or an imaging fluid. In one embodiment,the fluid delivery module comprises a conduit configured to deliverfluid to the needle through the tissue disintegration module. In anotherembodiment, the fluid delivery module comprises a conduit configured todeliver fluid directly to the needle. IN one embodiment, thepharmaceutically active agent is an agent for the local treatment ofbenign or malignant conditions, for example a chemotherapeutic,immunotherapeutic, or a radiotherapy agent.

In one embodiment, the system comprises a localisation marker deliverymodule configured to deliver a localisation marker through the needlebiopsy module. The marker may be a metallic marker, gel marker, or aprogrammable electronic marker detectable by any means including GPS,Bluetooth, or RF. In one embodiment, the localisation marker deliverymodule comprises a conduit configured to deliver a marker directly tothe needle.

In one embodiment, the system comprises a treatment module configured todeliver a therapy to a local site in the body, for example by means ofelectrophoresis, laser therapy or ablation therapy.

In one embodiment, the system comprises a needle guidance module,optionally forming part of the needle biopsy module. Typically, theneedle guidance module comprises a guidance part and an imaging partthat calibrates the guidance part. Typically, the imaging part isselected from x-ray radiography, mammography, ultrasound, nuclearmedicine, PET scan, PET CT scan, CT scan or MRI.

The invention also relates to a method of generating data relating to atissue core biopsy obtained from a patient comprising a step ofgenerating data relating to a tissue core biopsy obtained from thepatient using a system of the invention.

In one embodiment, the invention relates to a method of detecting oridentifying a tissue abnormality in a patient comprising a step ofgenerating data relating to a tissue core biopsy obtained from thepatient using a system of the invention, and correlating the data withthe presence or absence, or identity of, a tissue abnormality in thepatient.

In one embodiment, the invention relates to a method of determiningcancer status in a patient comprising a step of generating data relatingto a tissue core biopsy obtained from the patient using a system of theinvention, and correlating the data with the patients cancer status.

The invention also relates to a core needle biopsy device comprising aneedle biopsy module configured to obtain a tissue core from a locuswithin the body, and a tissue disintegration module operably connectedto the needle biopsy module and configured to receive the tissue corefrom the needle punch module, convert at least a portion of the tissuecore into gaseous tissue molecules, and optionally convey gaseous tissuemolecules from the tissue disintegration module to an analyser.

In one embodiment, the core needle biopsy module includes a tissue corecollection module. In one embodiment, the device is adjustable from afirst configuration in which the tissue disintegration module is alignedwith the core needle biopsy module for receipt of a tissue coretherefrom and a second configuration in which the tissue core collectionmodule is aligned with the core needle biopsy module for receipt of atissue core therefrom.

In one embodiment, the tissue core collection module and the tissuedisintegration module are provided on a first rotor configured forrotation from at least the first configuration to at least the secondconfiguration.

The invention also provides a core needle biopsy kit comprising:

-   -   a needle punch module configured to obtain a tissue core from a        locus within the body;    -   a tissue disintegration module configured for removable        attachment to the needle punch module, the tissue disintegration        module adapted to (a) receive a tissue core from the needle        punch module when attached thereto, (b) convert at least a        portion of the tissue core into gaseous tissue molecules, and        optionally (c) convey gaseous tissue molecules from the tissue        disintegration module to an analyser module; and    -   a tissue collection module configured for removable attachment        to the core needle biopsy module in place of the tissue        disintegration module for collection of one or more tissue cores        from the core needle biopsy module.

The core needle biopsy device or core needle biopsy kit may also includethe conveying means described above in connection with the system of theinvention.

BRIEF DESCRIPTION OF THE FIGURES

The invention will be more clearly understood from the followingdescription of some embodiments thereof given by way of example onlywith reference to the following figures in which:

FIG. 1 is an illustration of a system for generating data relating to atissue core according to a first embodiment of the invention;

FIG. 2 is an illustration of a system for generating data relating to atissue core according to a second embodiment of the invention, having arouting module and tissue core collection module;

FIG. 3 is an illustration of a system for generating data relating to atissue core according to a third embodiment of the invention, having arouting module that incorporates a storage function;

FIG. 4 is an illustration of a “plug-and-play” system of the inventionincluding separate collection and disintegration modules configured forremovable attachment to the needle biopsy module.

FIG. 5 shows a series of illustrations of a system according to theinvention including a needle biopsy module, disintegration module andcore collection module formed as a single, adjustable unit;

FIG. 6 is an illustration of a system similar to that of FIG. 5;

FIG. 7 is an illustration of a disintegration module forming part of thesystem or device of the invention;

FIG. 8 is an illustration of the disintegration module of FIG. 7 withthe outer chamber removed;

FIG. 9 is an illustration of an alternative design of disintegrationmodule forming part of the system or device of the invention; and

FIGS. 10 and 11 are illustrations of a core needle biopsy (CNB) deviceof the invention;

DETAILED DESCRIPTION OF THE INVENTION

The invention broadly provides a system for generating data relating toa tissue core comprising: a needle biopsy module configured to obtain atissue core from a locus within the body; a tissue disintegration moduleoperably connected to the needle biopsy module and configured to receivethe tissue core from the needle biopsy module and convert at least aportion of the tissue core into gaseous tissue molecules; and optionallyan analyser module operably connected to the disintegration module andconfigured to receive the gaseous tissue molecules from thedisintegration module, analyse the gaseous tissue molecules, andgenerate data relating to the tissue core based on the gaseous tissuemolecules.

Generally, the data collected relates to one or more constituents of thegaseous tissue molecules, which can be correlated with the presence orabsence of chemicals and by measuring the mass-to-charge ratio andabundance of gas-phase ions as well as specific proteins, peptides,amino acids, metabolites, drugs, contaminants, microorganisms, etc. Forexample, the presence of certain metabolites can inform on the presenceof a tissue abnormality, for example cancer or another disease. Methodsof analysis of cellular tissue and biomolecules by mass spectrometry aredescribed in US2011215233, US2007114375, U.S. Pat. No. 5,869,344,US2008149822 and WO2010136887. Methods for analysis of cellular tissueand biomolecules to detect cancer are described in Ocak et al (Proc AmThorac Soc. 2009 6(2)); and Loo et al (Journal of the American Societyfor Mass Spectrometry Vol. 16, Issue 7, 2005).

When this system is employed to detect cancer (or other tissue relatedconditions), for every core that is disintegrated and analysed, it isgenerally necessary to take a duplicate core that is stored forcytological or histological analysis. Thus, the system of the invention,or core needle biopsy device of the invention, preferably comprises atissue core routing module having at least one core-receiving chamberand configured for adjustment to move the at least one chamber from afirst position disposed to receive the core from the core needle biopsymodule to one or more different positions. This allows the core to berouted to the disintegration chamber, or routed to an alternative moduleor destination.

The data collected may also relate to one or more constituents of thecore needle biopsy tissue, which can be analysed by spectroscopy. Forexample, the core needle biopsy tissue or the products of denaturing canbe analysed by spectroscopy or electromagnetic radiation for thepresence of certain types of material such as atoms, molecules, crystalsand nuclei. The presence of certain metabolites can inform on thepresence of a tissue abnormality, for example cancer or another disease.

Typically, the system, or core needle biopsy device, of the inventionfurther comprises a conveying module for conveying material within thesystem or device, for example the delivery of local anaesthetic to thebiopsy site, tissue cores, cleaning, spraying or flushing material, orgaseous tissue molecules. In one embodiment, the conveying modulecomprises two, optionally separate, conveying sub-modules. In oneembodiment, the conveying module comprises a vacuum pump module. Otherconveying modules are also envisaged.

Typically, the conveying module is configured to (i) convey a tissuecore biopsy from the needle punch module to another module, (ii) conveygaseous tissue molecules from the disintegration module to the analysermodule, and/or (iii) flush leftover tissue from the disintegrationmodule. When the system comprises a routing module, the conveying moduleis configured (i) convey a tissue core biopsy from the needle punchmodule to the routing module, (ii) convey a tissue core biopsy from therouting module to one or more modules, for example the disintegrationmodule or a storage module, (iii) convey gaseous tissue molecules fromthe disintegration module to the analyser module, and/or (iiii) flushleft over tissue from the disintegration module.

In another embodiment, the system or device of the invention comprises aflushing module configured to flush a part of the system or device (forexample the disintegration module, routing module chamber, or theneedle) with a flushing liquid to remove residual matter from the partof the system or device, especially blood and cells. In one embodiment,the flushing module is operatively connected to the disintegrationchamber and configured to flush the chamber with a flushing liquid andremove the flushing liquid and contaminants from the chamber. In anotherembodiment, the flushing module is operatively connected to one or moretissue core receiving chambers of the routing chamber and configured toflush the or each chamber with a flushing liquid and remove the flushingliquid and contaminants from the chamber. The flushing liquid mayinclude but is not limited to distilled water, saline, a catalystsolution or a dilute formaldehyde solution. Suitably, the flushingmodule comprises a reservoir of flushing fluid, pump means, and conduitmeans operatively connected to the reservoir and pump means andconfigured to pump flushing liquid from the reservoir to a chamber ofthe system (for example the denaturation module or a chamber of therouting module or the needle).

Typically, the needle punch module is a core biopsy needle punch (usedin core needle biopsy (CNB) procedures, stereotactic CNB procedures, andvacuum assisted core biopsy procedures). The needle punch modulegenerally comprises a tissue core conduit adapted to convey a tissuecore from lumen of the needle to the disintegration module or therouting module. Typically, the tissue core is conveyed by vacuum.

Suitably, the disintegration module is configured to ionize all or partof the tissue core. Typically, the disintegration module comprises aninner chamber configured to receive a tissue core and convert at least apart of the tissue core into gaseous tissue molecules, an outer chamberthat embraces the inner chamber, and a conduit providing fluidcommunication between the outer chamber and the analyser module, whereinthe inner chamber comprises a plurality of apertures configured to allowpassage of gaseous tissue molecules from the inner chamber to the outerchamber. Preferably, the inner chamber comprises a tray adapted to holdthe tissue core, or a cylinder configured to contain the tissue core.

Suitably, the inner chamber comprises a tissue disintegration element,for example a heating element. Preferably, the inner chamber is at leastpartly formed of a braided heating element.

Suitably, the analyser comprises a mass spectrometer optionally incombination with a data processor configured to receive data from themass spectrometer and process the data. The analyser may also comprise adata storage module, and a data comparison module configured to comparedata received from the mass spectrometer or data storage module withreference data. In one embodiment, the analyser comprises communicationmeans configured to send data generated by the mass spectrometer to aremote location for storage or data processing via any electroniccommunication means including but not limited to Bluetooth, SMSmessaging or via the internet.

The invention also provides a method of analysing tissue obtained from apatient comprising a step of generating data relating to a tissue coreobtained from the patient using a system of the invention, and analysingthe data. The analysis may be for the purpose of detecting(qualitatively or quantitatively) (a) an abnormality with the tissue (b)the presence of a particular metabolite in the tissue, (c) the presenceof a microbial contaminant in the tissue (d) the presence of a drug ordrug metabolite in the tissue. The abnormality to be detected mayinclude a disease selected from a malignancy (cancer or a metastasisthereof), a metabolic disease, an inflammatory disease, an autoimmunedisease, or a neurodegenerative disease. Examples of cancer are providedbelow. In a preferred embodiment, the analysis involves detectingcancer, especially bone, breast cancer, gynaecological, liver, lungcancer, lymphoproliferative cancer, prostate, renal, thyroid or ametastasis thereof. The analysis may involve comparing thepatient-specific data with reference data to detect a particularchemical, phenotype, disease, condition, compound, molecule, orcontaminant. In one embodiment, the analysis comprises generating a massspectrometer fingerprint from the tissue core data, and comparing themass spectrometer fingerprint with at least one reference fingerprint.Comparison may be visual, or performed by means of computer implementedcomparison software.

Definitions

“Tissue core” means a core or plug of tissue obtained from within thebody using core needle biopsy device. Generally, the core is cylindricalis shape and has a length of 1-2 cm and a width of 0.1 to 0.5 cm.

“Core needle biopsy module” or “core needle biopsy device” or “CNB”means a hand-held or robotically-controlled instrument comprising aneedle punch capable of obtaining a tissue core from a locus inside thebody in a minimally invasive manner. In particular, the term should beunderstood to mean core needle biopsy devices that employ vacuum meansto sequester a core of tissue and withdraw the core of tissue through alumen within the needle. Examples of CNB devices are described in Brundel Re et al, Minimally Invasive Breast Biopsies, Recent Results inCancer Research 173, Springer (ISBN 978-3-540-31403-5), especially thearticle entitled “Comparison of Large-Core Vacuum-Assisted Breast andBiopsy Excision Systems (Robert Wilson, Pages 23-41).

“Needle punch” means the type of needle employed in CNB devices andgenerally comprises a needle capable of being actuated to sequester acore of tissue from a locus inside the body. In one embodiment, theneedle punch is of the type having an internal retractable sheath thatcan be actuated to withdraw and retract to excise a core of tissuesequestered into the core of the needle.

“Locus within the body” means a location within the body that can beaccessed in a minimally invasive manner using a CNB device. Examples ofsuitable loci including but not limited to breast tissue, lung tissue,liver tissue, other organ tissues, lymph tissue, prostate tissue,gastrointestinal tissue, and respiratory tract tissue.

“Tissue disintegration module” means a device capable of receiving atissue core and treating the core to convert at least a part, andpreferably substantially all, of the tissue core to gaseous tissuemolecules (i.e. ionize all or part of the tissue). The module maycomprise a heating element that ionises the tissue, for example athermocouple or a chamber or tray formed of or comprising heatingelements or filaments.

“Analyser module” means an analysis system that can receive gaseoustissue molecules and perform a qualitative analysis of the molecules.Generally, the module comprises a mass spectrometer (MS), for example aMALDI-TOF MS, accelerator MS, Tandem MS, thermal ionisation MS (TIMS),and spark source MS (SSMS). Further examples of analyser and MSconfigurations suitable for the present invention are described inWO2010136887.

“Data relating to the tissue core” generally means data relating to thepresence, absence, or absolute or relative amounts of one or morecomponents, for example chemicals, proteins, peptides, amino acids,metabolites, drugs, drug metabolites, microorganisms, and components ofmicroorganisms.

“Tissue core routing module” means a device having at least onecore-receiving chamber and is configured for adjustment to move the atleast one chamber from a first position disposed to receive the corefrom the core needle biopsy module to one or more different positions(for example at least 2, 3, 4, 5, 6, or 7 different positions).Preferably, the routing module is configured to perform at least two ofthe following functions: store the core; convey the core to the tissuedisintegration module; and convey the core to a core collection module.Preferably, the routing module is adjustable to move the at least onechamber from the first position to a second position disposed to deliverthe core to the core disintegration module or a core collection module.In one embodiment, the core routing module comprises a plurality ofcore-receiving chambers, for example at least 3, 4, 5, 6, 7, or 8chambers.

“Tissue core collection module” means a chamber operatively connectedwith the routing module and adapted to receive and hold tissue coresfrom the routing module. In a preferred embodiment it is attached to therouting module. Ideally, it is detachable attached to the routingmodule.

“Tissue abnormality” means a non-normal tissue phenotype, for examplediseased tissue. Examples of tissue abnormalities include benign andmalignant tissue, inflammation, and infected tissue. The tissueabnormality may be solid, cystic or part solid-cystic. Tissuemalignancies include cancer, for example primary cancer and metastasesthereof. Generally, a cancer is a solid tumor. Examples of tumors aresolid tumors of the Chest (chest wall and pleura, mediastinum, lungs),Gastrointestinal (Oesophagus, stomach, duodenum, small bowel colon,liver biliary, pancreas, spleen, peritoneum, mesentery and omentum),Genitourinary (kidneys, bladder, prostate, urethra, male reproductivesystem), Musculoskeletal (bone tumours), Gynaecological, Breast,Neuroradiology. Endocrine tumours and lymphoma and others.

“Metabolite” means a product of the eukaryotic or prokaryotic metabolismincluding amino acids, chemicals, sugars, fatty acids, and precursors orderivatives thereof.

“Microbial contaminant” includes a bacteria, virus or fungus, or acomponent or metabolite thereof.

“Drug” means a pharmaceutically active agent indicated for theprevention or treatment of disease or conditions in mammals. “Drugmetabolite” means a break-down product of the drug as a result of thedrug being metabolised in a mammal.

“Hand-held” as applied to the core needle biopsy device means that thedevice is adapted to held by a user during use in a core needle biopsyprocedure.

Referring to the drawings, and initially to FIG. 1, there is illustrateda system for generating data relating to a tissue core according to afirst embodiment of the invention, and indicated generally by thereference numeral 1. The system 1 comprises a core needle biopsy (CNB)module 2, a tissue disintegration module 3 operatively connected to theCNB module 2 by means of a conduit 4, and a mass spectrometer 5 in fluidcommunication with the tissue disintegration module 3 by means of aconduit 6. In use, the CNB module is employed to obtain a tissue corefrom a patient and deliver the tissue core to the tissue disintegrator 3where the tissue core is converted to gaseous tissue molecules byheating. The gaseous tissue molecules are then conveyed to the massspectrometer 5 and analysed by the mass spectrometer to generate tissuespecific data 7.

Referring to FIG. 2 an alternative embodiment of the system of theinvention is shown, indicated generally by the reference numeral 20, inwhich parts described with reference to the previous embodiment areassigned the same reference numerals. In this embodiment, the systemcomprises a rotor 21 and a tissue core collection module 22, both ofwhich are located remotely to the CNB module 2. The rotor 21 comprises arevolving cylinder having a tissue core receiving chamber (not shown)that is movable from a first position where it aligns with conduits 4Aand 4B (thus allowing the a tissue core be conveyed from the biopsymodule 2 to the disintegration chamber 5 via conduit 6) to a secondposition where the tissue core chamber aligns with conduit 23 leading tothe core collection chamber. The use of this embodiment is the same asthat described in relation to FIG. 1 except that the rotor can beactuated to route tissue cores either to the disintegration module or tothe collection module. In practice, for every core that is disintegrateda duplicate core will need to be stored.

Referring to FIG. 3 an alternative embodiment of the system of theinvention is shown, indicated generally by the reference numeral 30, inwhich parts described with reference to the previous embodiments areassigned the same reference numerals. In this embodiment, the rotor 21comprises a rotating cylinder having a four tissue core receivingchambers (not shown, but see FIG. 6) and is capable of holding up tofour cores at any one time. In use, every second core received by therotor is routed to the disintegration module 3 and the remaining coresare held/collected within the rotor and eventually removed for furtheranalysis (histological or cytological).

Referring to FIG. 4 a “plug-and-play” embodiment of the system of theinvention is illustrated and comprises a CNB module 2 and separatetissue disintegration module 3 and core collection module 22 which areconfigured for removable attachment to the CNB module 2 (FIG. 4A). InFIG. 4B, the system is shown with the tissue disintegration module 3in-situ whereby cores obtained by the CNB module are withdrawn into thedisintegration module 3 by means of a vacuum generated through a conduit41. In FIG. 4C, the system is shown in core collection mode with thedisintegration module 3 removed and replaced with the core collectionmodule 22.

Referring to FIG. 4D, the core collection module is illustrated in moredetail and comprises an inner chamber 42 configured to operably connectwith the CNB device 2 for receipt of a tissue core from the CNB device,and an outer chamber 43 connected to a vacuum pump conduit 44 forremoval of excess fluids from the outer chamber. A distal end of theinner chamber 42 comprises a system of connectors 45 configured todeliver a flushing fluid to the inner chamber, and optionally to deliverother fluids (for example anaesthetic, catalyst, solvent) or alocalisation marker to the inner chamber.

Referring to FIG. 4E, the tissue disintegration module is shown in moredetail and comprises an inner chamber/thermocouple 46 that is alignedwith the CNB device 2 for receipt of a tissue core from the CNB device,and an outer chamber 47 connected to a vacuum pump conduit 48A forremoval of excess fluids from the outer chamber or a vacuum pump conduit48B for removal of gaseous molecules to an analyser module (not shown).A distal end of the inner chamber 46 comprises a connector 49 configuredto deliver a flushing fluid to the inner chamber. The innerchamber/thermocouple 46 is connected to an electrical supply allowingthe thermocouple disintegrate a tissue core contained within thethermocouple. The thermocouple is perforated with holes allowing gaseousmolecules pass into the outer chamber where they are removed by vacuumto the analyser.

Referring to FIG. 5, there is illustrated an embodiment of the systemhaving a CNB device 2, tissue disintegration module 3, and corecollection module 22 provided as a single unit. In this embodiment, thetissue disintegration module 3 and core collection module 22 areprovided on a first rotor 51 configured for rotation relative to the CNBdevice 2 between a number of different configurations. The unit alsoincludes a second rotor 52 operably connected to a purging vacuumconduit 53 and a gaseous molecule extraction conduit 54. In a firstconfiguration shown in FIG. 5A, the core collection chamber 22 isaligned with the CNB device 2 and the purging vacuum conduit 53 suchthat a first tissue core is extracted from a site and captured in thecollection chamber. All impurities are vacuumed from the sample and itis retained within the chamber until the sampling process is complete.In a second configuration shown in FIG. 5B, the rotors 51 and 52 haverotated to align the CNB device 2 with the tissue disintegration module3 and the purging vacuum conduit 53 resulting in a second tissue corebeing extracted and delivered to the disintegration module 3. The firsttissue core in the collection chamber 22 is now aligned with the gaseousmolecule extraction conduit 54. In the third configuration shown in FIG.5C, the rotor 51 is rotated such that the disintegration module 3 isaligned with the gaseous molecule extraction conduit 54. As shown inFIG. 4D, electrical terminals 57 on the disintegration module 3establish electrical connection with corresponding terminals on thesecond rotor 52 causing the tissue disintegration module to actuate anddisintegrate the tissue core whereby gaseous molecules generated arewithdrawn to an analyser for analysis.

Referring to FIG. 6, there is illustrated a further embodiment of thesystem shown in FIG. 5 in which parts identified with reference to theprevious embodiment are assigned the same reference numerals. In thisembodiment the tissue disintegration module 2 and core collection module22 mounted on the rotor 51 are contained within an outer chamber 60connected to a purging vacuum through conduit 62. A conduit 63 isconnected to the collection module 22 for the purpose of flushing themodule with a flushing fluid and a similar conduit 64 is connected tothe disintegration module 2 for the purpose of flushing the module 2. Afurther conduit 65 provides fluid connection between the outer chamber60 and the analyser (not shown). A distal end of the outer chamber 60comprises a system of connectors 66 configured to deliver a flushingfluid to the inner chamber, and optionally to deliver other fluids (forexample anaesthetic, catalyst, solvent) or a localisation marker to theinner chamber.

Referring to FIGS. 7 and 8 these is illustrated a disintegration moduleforming part of the system or device of the invention, indicatedgenerally by the reference numeral 70 and comprising an inner chamber(in this case a tray 71 formed of a braided heating element), and anouter chamber comprising insulated ends 73, 74 and an insulated heatresistant glass tube 75. The distal end 73 comprises an aperture 76configured for engagement with conduit 4A leading to the CNB device 2.The proximal end 74 comprises a aperture 77 in fluid communication witha conduit 6 leading to the analyser module 5, and a second aperture 78in fluid communication with a vacuum pump (not shown) via conduit 79 forthe purpose of pressuring the system and conveying tissue cores from theCNB device and routing module to the disintegration module 70. Valvesare associated with both of apertures 73 and 74 and the valve associatedwith aperture 74 is configured to open when a vacuum is applieddownstream of the valves. In use, a vacuum pump (not shown) is actuatedto apply a negative pressure in conduit 79 causing the valve in aperture74 to open and depressurisation of the disintegration module 70 andconduit 4A. This results in the tissue core in conduit 4A being drawninto the module 70 and falling onto the tray 71. Valves are then closedand the heating element is actuated to ionize the tissue core 81 andgaseous tissue is withdrawn to an analyser 5 via the conduit 6.

FIG. 9 illustrates an alternative embodiment of the disintegrationmodule (80) in which the inner chamber comprises a tray 81 formed ofbraided heating filaments.

FIGS. 10 and 11 illustrate a core needle biopsy (CNB) device 90comprising a needle punch module 91 configured to obtain a tissue corefrom a locus within the body, and a tissue disintegration module 70 (asdescribed previously) operably connected to the needle punch module andconfigured to receive the tissue core from the needle punch module andconvert at least a portion of the tissue core into gaseous tissuemolecules. The use of this device is the same as that describedpreviously.

In practice, the CNB device is for use within a hospital or clinicsetting. The device is for use on benign and malignant appearingtissues. The tissue abnormality maybe non palpable or palpable. The CNBdevice for use under image guidance may be by free hand or by use ofstereotactic guidance. If the area is easily felt, the biopsy needle maybe guided into the tumor while feeling (palpating) the lump. The CNBdevice is generally for use with image guidance. Image guidance devicesconsist of a number of modalities. The image modality to guide the CNBdevice includes but is not limited to x-ray radiography, mammography,ultrasound, nuclear medicine, PET scan, PET CT scan, CT scan or MRI. TheCNB image device is calibrated to the imaging modality.

The tissue abnormality, generally appears as an image of the tissue onan imaging modality device. The tissue abnormality may be evident on oneimaging modality but not on another. Local anaesthetic is injected intothe skin where the CNB device is to be inserted. The CNB device isinserted using image guidance into the tissue abnormality using one ofthe above imaging modalities. Local anaesthetic in instilled via a portinto the locus of the biopsy site using the CNB device.

During the CNB procedure, the hollow CNB device is used to withdrawsmall cylinders (or cores) of tissue from the abnormal area within thebreast. A CNB is most often done in a doctor's office with localanesthesia. The needle is put into the abnormal tissue to get thesamples, or cores. The doctor doing the CNB usually places the needle inthe abnormal area using ultrasound or x-rays to guide the needle intothe right place.

A stereotactic core needle biopsy uses x-ray equipment and a computer toanalyze pictures of the breast. The computer then pinpoints exactlywhere in the abnormal area the needle tip needs to go. This is oftendone to biopsy suspicious microcalcifications (tiny calcium deposits)when a tumor cannot be felt or seen on ultrasound.

Vacuum-assisted biopsies can be done with systems like the Mammotome® orATEC® (Automated Tissue Excision and Collection). For these procedures,the skin is numbed and a small cut (less than ¼ inch) is made. A hollowprobe is put in through the cut and guided into the abnormal area ofbreast tissue using x-rays, ultrasound, or MRI. A cylinder of tissue isthen pulled into the probe through a hole in its side, and a rotatingknife inside the probe cuts the tissue sample from the rest of thebreast.

These methods allow multiple tissue samples to be removed through onesmall opening. They are also able to remove more tissue than a standardcore biopsy. Vacuum-assisted core biopsies are done in outpatientsettings.

A Magnetic resonance imaging (MRI) guided biopsy guides the biopsy. Forinstance, with the ATEC system, you lay face down on a special tablewith an opening that your breast fits into. Computers are then used tofind the tumor, plot its location, and help aim the probe into thetumor. This is helpful for women with a suspicious area that can only befound by MRI.

The CNB device consists of a port to permit the insertion of alocalization marker at the site of the core needle biopsy. The devicemay include but is not limited to metallic, gel or programmableelectronic markers. All of the above tissue localization markers can bedetected by one of the following x-ray radiography, mammography,ultrasound, nuclear medicine, PET scan, PET CT scan, CT scan or MRI. Thelocalisation markers listed above are compatible and safe to use withall of the above imaging modalities.

The invention is not limited to the embodiments hereinbefore describedwhich may be varied in construction and detail without departing fromthe spirit of the invention.

1. A system for generating data relating to a tissue core, comprising: acore needle biopsy module configured to obtain tissue core from a locuswithin the body; a tissue disintegration module operably connected tothe core needle biopsy module and configured to receive the tissue corefrom the core needle biopsy module and convert at least a portion of thetissue core into gaseous tissue molecules; a first vacuum pumpconfigured to convey the tissue core from the needle biopsy module tothe tissue disintegration module; and a second vacuum pump configured toconvey gaseous tissue molecules from the tissue disintegration module toan analyser module.
 2. A system as claimed in claim 1 including ananalyser module operably connected to the second vacuum pump for receiptof the gaseous tissue molecules from the disintegration module, andconfigured to analyse the gaseous tissue chemicals or molecules, andgenerate data relating to the tissue core based on the gaseous tissuemolecules.
 3. A system as claimed in claim 2 in which the analysermodule comprises a mass spectrometer.
 4. A system according to anypreceding claim in which the core needle biopsy module and tissuedisintegration module are provided as a single unit, and wherein thetissue disintegration module is removably attached to the core needlebiopsy module.
 5. A system according to claim 4 including a tissue corecollection module configured for removable attachment to the core needlebiopsy module in place of the tissue disintegration module, in which thetissue core collection module is configured for collection of one ormore tissue cores from the core needle biopsy module.
 6. A systemaccording to any of claims 1 to 3 and including a tissue core collectionmodule, wherein the tissue disintegration module, the core needle biopsymodule, and the tissue core collection module are provided as a singleunit, wherein the unit is adjustable from a first configuration in whichthe tissue disintegration module is aligned with the core needle biopsymodule for receipt of a tissue core therefrom and a second configurationin which the tissue core collection module is aligned with the coreneedle biopsy module for receipt of a tissue core therefrom.
 7. A systemaccording to claim 6 in which the tissue core collection module and thetissue disintegration module are provided on a first rotor configuredfor rotation from at least the first configuration to at least thesecond configuration.
 8. A system as claimed in any preceding claim inwhich the first vacuum pump and second vacuum pump are provided on asecond rotor that is operably connected to the first rotor for rotationrelative to the first rotor from a first configuration in which thefirst vacuum pump is aligned with the tissue disintegration module to asecond configuration in which the second vacuum pump is aligned with thetissue disintegration module.
 9. A system as claimed in any precedingclaim in which the disintegration module comprises an inner supportconfigured to receive a tissue core biopsy and convert at least a partof the tissue core biopsy into gaseous tissue molecules, an outer gasimpermeable chamber, and an outlet conduit in fluid communication withthe second vacuum pump.
 10. A system as claimed in any preceding claimincluding means for delivering an active agent or a localisation markerto a locus within the body.
 11. A method of determining cancer status ina patient comprising a step of generating data relating to a tissue corebiopsy obtained from the patient using a system of any of claims 1 to 9,and correlating the data with the patient's cancer status.
 12. A coreneedle biopsy device comprising a needle punch module configured toobtain a tissue core from a locus within the body, and a tissuedisintegration module operably connected to the needle punch module andconfigured to receive the tissue core from the needle punch module,convert at least a portion of the tissue core into gaseous tissuemolecules, and convey gaseous tissue molecules from the tissuedisintegration module to an analyser.
 13. A core needle biopsy deviceaccording to claim 12 and including a tissue core collection module,wherein the device is adjustable from a first configuration in which thetissue disintegration module is aligned with the core needle biopsymodule for receipt of a tissue core therefrom and a second configurationin which the tissue core collection module is aligned with the coreneedle biopsy module for receipt of a tissue core therefrom.
 14. A coreneedle biopsy device according to claim 12 or 13 in which the tissuecore collection module and the tissue disintegration module are providedon a first rotor configured for rotation from at least the firstconfiguration to at least the second configuration.
 15. A core needlebiopsy kit comprising: a needle punch module configured to obtain atissue core from a locus within the body; a tissue disintegration moduleconfigured for removable attachment to the needle punch module, thetissue disintegration module adapted to (a) receive a tissue core fromthe needle punch module when attached thereto, (b) convert at least aportion of the tissue core into gaseous tissue molecules, and optionally(c) convey gaseous tissue molecules from the tissue disintegrationmodule to an analyser module; and a tissue collection module configuredfor removable attachment to the core needle biopsy module in place ofthe tissue disintegration module for collection of one or more tissuecores from the core needle biopsy module.